Individual
THOMAS DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 ANNETTE AVE, INTERLACHEN, FL 32148-5106
(352) 519-6427
Mailing address
505 ANNETTE AVE, INTERLACHEN, FL 32148
(352) 519-6424
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
RT10947
FL
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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